C09995078 / invoice 10000

Reason: Had A Collapsing Episode Wants A CheckAppointment Notes: Overdue reminders I suggested starting with bloods as he seems back to normal now ALHistory: This morning walked in to owners room and "couldn't walk". Walked in normally but then had tremors and spasms of his front legs. Did not lose conciousness and did not fall over, just had about 30 seconds of strange spasms. Runs around wild in general. A very energetic Groodle. Has had a couple of these episodes before. Last time was January last year. Happens at any time of the day. This time was first thing in the morning, last time was after being really active and getting home. Not on any other medication. Flea/tick/worming prevention UTD. Dental score: 1/4 - a little dirty but not too bad.Body Condition Score: 5/9Pain Assesment Score: 0/4Physical Examination: Walking normally today. Bouncing around in consult and constantly jumping up on me. Not very well trained or controlled. Eyes - normal and consensual PLR, no nystagmus, 2 small meibomian gland swellings on central upper eyelid of the left eye. Ears NADNose NADMouth NADThoracic ausc normal. No heart murmur, lungs clear. Abdominal palpation normal. No discomfort, abdomen soft and bladder normal size. Normal proprioception in all 4 limbs. No ataxia. Palpation of spine NADManipulation of neck - repeatable pain response on full lateral movement to the right. Hips - reduced ROM in both, unable to fully extend them. Stifles and Elbows NADShoulders - unabel to get full extension. Differential Diagnosis: Partial seizure episodes vs Osteoarthritic pain/nerve pain vs underlying organ dysfunction. Laboratory: Recommend bloods to rule out underlying health issues. Owner consents. Bloods all normal. Slightly low amylase which is not significant and all other parameters are in the normal range. Treatment: Meloxicam trial recommended. See if this improves things - will prevent Archie pulling up sore after lots of exertion. If helps could consider long term supplements like antinol or beransa rather than staying on meloxicam long term as these episodes are very sporadic and not very frequent. Spoke to owner about this and she is not interested at this stage. I recommended starting antinol if we aren't going to trial meloxicam, this will help the joints long term. She declined at this stage. Discussed with owner that we cannot rule out a neuro episode and that if they start to become regular, then further workup is warranted.    Vital Signs    Weight: 25.2;       MMColour: pink;       HeartRate: 112;       BodyScore: 5/9;       DentalGrade: 1/4;       RespirationRate: 20;       CRT: 1 ssec ;